'Obamacare' means health insurance changes on way in Mass.

Wednesday

Sep 25, 2013 at 12:01 AMSep 25, 2013 at 7:10 PM

Massachusetts led the way with landmark health care reform in 2006, when then-Gov. Mitt Romney signed legislation that required all residents to have health insurance, regardless of their income level. The state created low-cost subsidized health insurance plans for people who had no other means of purchasing health coverage. That model is now being rolled out to the nation under the new federally mandated Affordable Care Act, dubbed “Obamacare.”

Deborah Allard

Massachusetts led the way with landmark health care reform in 2006, when then-Gov. Mitt Romney signed legislation that required all residents to have health insurance, regardless of their income level.

The state created low-cost subsidized health insurance plans for people who had no other means of purchasing health coverage.

Currently, 98.1 percent of adults and 99.8 percent of children are insured in Massachusetts.

That model is being rolled out to the nation under the new federally mandated Affordable Care Act, dubbed “Obamacare.”

Millions of people in the United States will, for the first time, be eligible for low-cost health insurance.

For Massachusetts, changes are on the way.

About 200,000 Massachusetts residents who already receive subsidized health insurance through the state’s Commonwealth Care programs will need to choose new plans by the end of the year.

Starting Tuesday, Commonwealth Care will cease to exist. Coverage will continue until at least the end of the year.

The state will transition to the Affordable Care Act model and begin offering new health insurance plans that meet federal qualifications.

The Affordable Care Act will require all states to provide access to an online marketplace where individuals and small businesses can compare and purchase private health insurance policies.

Massachusetts will continue to use its online Health Connector, which will become a federally compliant health insurance exchange starting Tuesday.

“Yes, we will be ready,” said Jason Lefferts, director of Communications for the Commonwealth Health Connector.

Lefferts said members of Commonwealth Care insurance programs, such as BMC HealthNet, Neighborhood Health, Network Health and others, will need to participate in open enrollment and choose a new plan through the Health Connector before the end of the year.

The state will be mailing letters and phoning members to make sure they are aware of the changes and sign up for a new plan to avoid an interruption in coverage.

“I think for consumers, it’s all good news,” Lefferts said.

There will be several changes made to health insurance programs.

More people will be eligible for Commonwealth Health Connector programs, including MassHealth (Medicaid).

In 2014, people with incomes of up to 400 percent of the federal poverty level will qualify for low-cost health insurance. Currently, the level is set at 300 percent of the poverty level.

Today, a person with a yearly income of more than $33,000 does not qualify for subsidized health insurance. In 2014, a person can make up to approximately $46,000 and qualify for insurance.

A family of four will be eligible if they make $88,000.

Massachusetts residents will also benefit from expanded funding for community health centers, assistance with prescription drug costs for seniors, and tax credits for small employers.

Employers with more than 50 workers will face stiffer penalties, up to $2,000 per worker, for not offering health insurance coverage. There will also be a penalty for employers who offer health insurance that is not considered affordable under the new federal law.

As the state tweaks its own subsidized health insurance programs to bring them into compliance, those who work in health care are short on details.

Paulette Couture, patient benefits supervisor at HealthFirst Family Care Center, a community clinic that serves people who are uninsured, underinsured and have low incomes, said information was coming to her slowly.

Couture and other staffers met last week with a provider from Neighborhood Health Plan, one of several insurers that currently offers subsidized health insurance in the state.

Neighborhood Health, and others, will continue to sell low-cost plans.

Couture said she signs up between 100 and 150 people each month for subsidized insurance, whether or not they are patients of HealthFirst.

“Anyone can come in,” Couture said. “We do it for the whole community.”

Couture said she believes the Affordable Care Act will benefit Massachusetts residents. She said it will also help nearby Rhode Island residents who have not had the benefit of low-cost health insurance.

Cynthia Wicks, president of the Southcoast Health System’s Southcoast Physicians’ Network, said the group, including its private physicians and its hospitals, is ready and will accept all of the different insurance plans.

“We’re totally prepared and cognizant of how this will work,” Wicks said. “There won’t be a lot of changes (for patients).”

Wicks said once all Rhode Islanders are required to have health insurance, it will further benefit patients needing care at any of the many Southcoast physician offices in the area.